Evaluation of Gallbladder Diseases

Gallbladder diseases are very common entities with diverse features of presentation at clinical, radiological and pathological settings with variable morbidities and mortalities. It implies an altered hepatobiliary function. A majority of gallbladder diseases involve gallstones, which form about 95% of all gallbladder diseases. The noncalculus disease forms only about 4–5% of the cases. Inflammations of gallbladder, either acute or chronic, are commonly seen in association with calculus gallbladder. Benign neoplasms are very rare compared to malignant neoplasms that are more common but uncommon compared to inflammatory conditions. Gallbladder diseases are very common and it is appropriate to emphasise that knowledge of these diseases is imperative. In the present study of 50 patients an attempt was made to correlate the clinical, radiological and pathological features of gallbladder diseases and to ascertain the sensitivity of ultrasound in the evaluation of gallbladder diseases. The radiological diagnosis in gallbladder diseases had favourable results against the clinical diagnosis and has also been shown to be impressive against the pathological diagnosis. In our study the radiological diagnosis of gallbladder diseases is shown with reference to most of the disease conditions.

Characteristics of Gallbladder Sludge Shown as a Sonographic Pseudo-Tumor

BACKGROUND: Due to its high diagnostic accuracy, preoperative sonographic evaluation of gallbladder disease is accepted as the most reliable and effective procedure. However we have encountered, though not so often, cases in which the sonographic tumor revealed only sludge material in reality. METHODS: A retrospective review of 11 cases that had been preoperatively diagnosed as a gallbladder mass or stone focused on the features of the patients and the characteristics of the sonographic findings. RESULTS: Of the cholecystectomized 2486 cases in which gallstones or gallbladder polyps had been preoperatively diagnosed, 0.4% had only sludge in reality. Symptomatic patients were 7 (64%). Pseudo- tumorous lesions of the gallbladder resembled the shapes of the stones, as well as the shapes of polyps, in their echogenic characteristics. CONCLUSIONS: Gallbladder sludge alone can make the sonographic image of a stone or a polyp. The application of more advanced sonography, such as contrast-enhanced Doppler sonography, may contribute to the differential diagnosis of pseudo-tumorous lesions of the gallbladder; however, an indefinite lesion on sonography always deserves operative intervention.

A Case of Ceftriaxone-induced Pseudocholelithiasis

Ceftriaxone, a third-generation cephalosporin, is a very potent, broad spectrum antibiotic commonly used in patients with meningitis, osteomyelitis, pyelonephritis, Lyme disease and many other severe infectious diseases. Up to 46% of those receiving this antibiotic develop gallbladder sludge. Most of them are asymptomatic, but a small proportion may develop right upper quadrant pain, nausea, vomiting and even cholecystitis. We report a case of ceftriaxone-induced pseudocholelithiasis in a 5-year-old boy. We also emphasize the fact that surgical interventions such as cholecystectomy is not necessary, because the condition may resolve spontaneously after cessation of the drug.